Does a radiation dose-response relation exist concerning survival of patients who have soft-tissue sarcomas of the extremities? Radiation dose - Response relation for soft-tissue sarcomas

Aaron Wolfson, Pasquale W Benedetto, Walid Mnaymneh, Frederick L Moffat, David S. Robinson, Cynthia Boyer, William A. Raub, Robert C. Duncan, Arnold Markoe

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17 Citations (Scopus)

Abstract

This study analyzes a single-institution experience by evaluating the impact on survival of increasing total dose of adjunctive irradiation in patients who had extremity soft-tissue sarcoma (ESTS). A retrospective review of the tumor registry at a university medical center from January 1984 through December 1992 yielded a total of 59 surgical patients of ESTS. With follow-up ranging from 30 to 135 months (median, 65 months), the 2-, 5-, and 8-year overall and disease-free survival for all patients was 86%, 71%, 58% and 76%, 70%, 56%, respectively. Multivariate analyses using the Cox proportional hazards model revealed that total radiation dose (p = 0.02), American Joint Committee on Cancer stage (p = 0.04), and tumor size (p = 0.006) were all significant prognostic factors of overall survival; however, only tumor size was predictive of disease-free survival (p = 0.02). When the effect of tumor size and disease stage were controlled in the Cox model, a dose-response curve between increasing total radiation dose and improved overall patient survival was indicated. This study demonstrates the significance of tumor size on predicting both overall and disease-free survival in patients who have soft-tissue sarcomas of the extremity. It also suggests, however, that a radiation dose-response relation may exist for overall survival. Future investigations should consider evaluating the minimal total radiation dose needed to optimize patient survival after limb- sparing surgery.

Original languageEnglish
Pages (from-to)270-274
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume21
Issue number3
DOIs
StatePublished - Jun 1 1998

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Sarcoma
Extremities
Radiation
Survival
Disease-Free Survival
Neoplasms
Proportional Hazards Models
Registries
Multivariate Analysis

Keywords

  • Dose-response relationship
  • Radio therapy
  • Soft-tissue sarcoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

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title = "Does a radiation dose-response relation exist concerning survival of patients who have soft-tissue sarcomas of the extremities? Radiation dose - Response relation for soft-tissue sarcomas",
abstract = "This study analyzes a single-institution experience by evaluating the impact on survival of increasing total dose of adjunctive irradiation in patients who had extremity soft-tissue sarcoma (ESTS). A retrospective review of the tumor registry at a university medical center from January 1984 through December 1992 yielded a total of 59 surgical patients of ESTS. With follow-up ranging from 30 to 135 months (median, 65 months), the 2-, 5-, and 8-year overall and disease-free survival for all patients was 86{\%}, 71{\%}, 58{\%} and 76{\%}, 70{\%}, 56{\%}, respectively. Multivariate analyses using the Cox proportional hazards model revealed that total radiation dose (p = 0.02), American Joint Committee on Cancer stage (p = 0.04), and tumor size (p = 0.006) were all significant prognostic factors of overall survival; however, only tumor size was predictive of disease-free survival (p = 0.02). When the effect of tumor size and disease stage were controlled in the Cox model, a dose-response curve between increasing total radiation dose and improved overall patient survival was indicated. This study demonstrates the significance of tumor size on predicting both overall and disease-free survival in patients who have soft-tissue sarcomas of the extremity. It also suggests, however, that a radiation dose-response relation may exist for overall survival. Future investigations should consider evaluating the minimal total radiation dose needed to optimize patient survival after limb- sparing surgery.",
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AU - Benedetto, Pasquale W

AU - Mnaymneh, Walid

AU - Moffat, Frederick L

AU - Robinson, David S.

AU - Boyer, Cynthia

AU - Raub, William A.

AU - Duncan, Robert C.

AU - Markoe, Arnold

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